A complete atrioventricular block is seen in patients due to a variety of causes, including drugs. The resolution of a drug-induced atrioventricular block is often accomplished by drug discontinuation. We report a case of a complete atrioventricular block in a 31-year-old woman following a month of treatment with evening primrose oils. After excluding all other likely causes of conduction disorders, an adverse effect of the evening primrose oils seemed to be the most likely diagnosis. After discontinuation of the oils, no associated symptoms or conduction disturbances were observed for 4 months after discharge. We stress the reconsideration of taking medicines and functional foods continuously as most patients are not aware of the hazards they pose.
Adult ; Atrioventricular Block* ; Diagnosis ; Female ; Functional Food ; Humans ; Oenothera biennis* ; Oils

Percutaneous mitral balloon valvuloplasty (PMBV) is the treatment of choice for mitral stenosis. Only a few reported cases have been reported in PMBV patients worldwide. In this study, a case of a 34 year-old female with infective endocarditis a year after PMBV is presented. The patient presented with fever, and peripheral vascular symptoms. Transthoracic echocardiography showed vegetation on the anterior mitral leaflets and Staphylococcus Viridans was isolated from blood cultures. The patient was successfully treated with Amoxicillin + Clavulate and Gentamicin. Further studies on the correlation between PMBV and infective endocarditis are needed.
Amoxicillin ; Balloon Valvuloplasty* ; Echocardiography ; Endocarditis* ; Female ; Fever ; Gentamicins ; Humans ; Mitral Valve Stenosis ; Staphylococcus

Benign paroxysmal positional vertigo (BPPV) is a commonly presenting problem at the emergency department. Three types have been recognized based on the pathogenesis of BPPV. The first is posterior-canal canalolithiasis, the second is horizontal-canal canalolithiasis, and the last is horizontal-canal cupulolithiasis. With the first two types of BPPV, an otolith-repositioning manuever can be performed quickly at the bedside with rapid results, often providing much satisfaction to both patient and physician. However, in the case of horizontal-canal cupulolithiasis, no established repositioning maneuver existed until recently. In 2000, Jo et al. developed a new repositioning maneuver and reported excellent results. We report a case of BPPV horizontal-canal cupulolithiasis that immediately responded to the maneuver of Jo et al. and strongly recommend use of this repositioning maneuver at the emergency department.
Emergency Service, Hospital ; Humans ; Semicircular Canals* ; Vertigo

No abstract available.
Atrioventricular Block*

A three-year-old female beaver (Castor canadensis) was referred to the Veterinary Teaching Hospital of Chungbuk National University. It had been raised in the Cheong-ju zoo and had a history of malocclusion caused by improper feeding. General anesthesia was induced, and preoperative intraoral dental radiographs of the rostal maxillary and mandibular dentition were taken and lateral and ventrodorsal extraoral radiographs of the cheek teeth were also taken. The radiographs were negative for apical pathology and revealed a normal appearance of the cheek teeth. The lesion was likely to be related to the excessive length of the maxillary and mandibular incisors. Odontoplasty was performed to reduce overgrowth of the crowns of the incisors. Sequential transverse sections were removed until the crown was reduced by approximately its original length. The pulp chamber was not approached during the operation, as confirmed by postoperative intraoral radiographic evaluation of the incisors. Recovery from anesthesia was uneventful and the beaver returned to normal masticatory activities immediately after the operation.
Animals ; Animals, Zoo ; Female ; Incisor/pathology/*surgery ; Malocclusion/pathology/surgery/*veterinary ; Rodentia/*surgery

Systemic lupus erythematosus is a multisystemic autoimmune disease in which the kidneys are frequently involved. Clinical diagnosis of SLE is based on the criteria of American Rheumatism Association (ARA). A few cases who were classified as SLE by the ARA criteria but were antinuclear antibody (ANA)-negative have been reported. It was reported that critical factor in ANA positivity is the choice of substrate. It is generally accepted that the cultured cell of human origin, especially HEP-2 cell, is better than tissue section or animal cells. Thus, the ANA test is negative only in approximately 2M of SLE patients when human tissue culture cells are used as substrate. We report a 25-year-old man admitted to our hospital because of generalized edema. He was found to have active lupus nephritis(WHO class IV), photosensitivity and pancytopenia. The result of FANA test which used HEP-2 cell as substrate was repeatedly negative, but anti-ds DNA and anti-Ro antibody were positive.
Adult ; Animals ; Antibodies, Antinuclear ; Autoimmune Diseases ; Cells, Cultured ; Diagnosis ; DNA ; Edema ; Humans ; Kidney ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Pancytopenia ; Rheumatic Diseases

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.
Cardiac Output ; Echocardiography* ; Hematocrit ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Mortality ; Renal Dialysis ; Transplantation*

Eosinophilic gastroenteritis is an uncommon disease of unknown etiology that is characterized by massive tissue infiltration of eosinophils in the tissue layers of various areas of the gastrointestinal tract. An accurate diagnosis is difficult as clinical presentations, symptoms, endoscopic and radiologic findings are nonspecific. A 51-year-old man visited our hospital presenting with abdominal pain. Esophagogastroduodenoscopy revealed diffuse hyperemic mucosal lesions at the stomach, duodenum. Symptoms and endoscopic findings deteriorated rapidly after three days. Small amounts of eosinophilic infiltration without malignant cells was confirmed from biopsy. However, we could not exclude malignancy and performed a subtotal gastrectomy. Stomach specimen showed eosinophilic infiltrations, and the patient was finally diagnosed as eosinophilic gastroenteritis. We report a case of atypical eosinophilic gastritis with rapid deterioration mimicking Borrmann type 4 advanced gastric cancer.
Abdominal Pain ; Biopsy ; Diagnosis ; Duodenum ; Endoscopy, Digestive System ; Eosinophils* ; Gastrectomy ; Gastritis ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Middle Aged ; Stomach ; Stomach Neoplasms*

PURPOSE: Tooth injuries are common complaints presenting at emergency departments, so emergency physicians (EP) should play an important role in the initial care of dental trauma. However, there has been little interest in and research on this subject. Examining the various clinical factors helpful for the emergency physician's care of tooth injuries, we attempted to acquire basic data for establishing treatment guideline. METHODS: A retrospective analysis was done by reviewing the dental charts of 214 patients who presented to the emergency departments of one secondary hospital and one tertiary hospital following tooth injuries during a 1-year period (Oct. 2000-Sept. 2001). The following variables were extracted and examined: age, mechanism of injury, number and location of injured teeth, radiograph performance, diagnosis, type of treatment. RESULTS: With the 1992-WHO classification, 9 types of tooth injuries were found (multiple response): in adults, concussion (23.5% of cases), subluxation (16.7%), pulp-exposed crown fracture (16.7%), avulsion (10.8%), and non-pulpexposed crown fracture(15.7%); in children, subluxation (20.2%), luxation (17.2%), avulsion (17.2%), and concussion (11.1%), Seven types of treatment were performed based on single most difficult treatment recorded per patient: 91 conservative cares (42.5% of cases), 9 pulp cappings (4.2%), 49 splints (22.9%), 7 replantations (3.3%), 17 pulpectomies (7.9%), 30 extractions (14.0%), and 10 others. CONCLUSION: Considering that the most prevalent treatments were splints and conservative cares, we think emergency medicine could play a wide role in the initial management of tooth injuries and suggest a further co-study with a dentist.
Adult ; Child ; Classification ; Crowns ; Dental Pulp Capping ; Dentists ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Pulpectomy ; Replantation ; Retrospective Studies ; Splints ; Tertiary Care Centers ; Tooth Injuries* ; Tooth*

The syndrome of diffuse intravascular coagulation or DIC was related with high perinatal mortality & morbidity. One of the most common cause of clinically significant DIC is placental abruption Usually, DIC complicates this obstetrical accident in approximately 30% of cases. The majority of placental abruption occured late pregnancy. But, recently we have experienced a case of DIC in a patient with placental abruption in 16 weeks of gestationl age and reviewed it briefly
Abruptio Placentae* ; Dacarbazine ; Female ; Gestational Age* ; Humans ; Perinatal Mortality ; Pregnancy